Antibody Development and Disease Severity of Covid-19 in Non-Immunized Patients with Rheumatic Immune-Mediated Inflammatory Diseases: Data from a Prospective Cohort Study

2021 ◽  
Author(s):  
Laura Boekel ◽  
Femke Hooijberg ◽  
Erik Vogelzang ◽  
Yaëlle Besten ◽  
Maureen Leeuw ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Inflammatory Diseases ◽  
Immune Mediated

scholarly journals Evaluation of the mechanisms of sarcopenia in chronic inflammatory disease: protocol for a prospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amritpal Dhaliwal ◽  
Felicity R. Williams ◽  
Jonathan I. Quinlan ◽  
Sophie L. Allen ◽  
Carolyn Greig ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Inflammatory Disease ◽  
Prospective Cohort ◽  
Inflammatory Diseases ◽  
Chronic Inflammatory Disease ◽  
Assessment Model ◽  
Chronic Inflammatory Diseases ◽  
Link Type ◽  
Disease Specific

Abstract Background Several chronic inflammatory diseases co-exist with and accelerate sarcopenia (reduction in muscle strength, function and mass) and negatively impact on both morbidity and mortality. There is currently limited research on the extent of sarcopenia in such conditions, how to accurately assess it and whether there are generic or disease-specific mechanisms driving sarcopenia. Therefore, this study aims to identify potential mechanisms driving sarcopenia within chronic inflammatory disease via a multi-modal approach; in an attempt to help define potential interventions for future use. Methods This prospective cohort study will consist of a multi-modal assessment of sarcopenia and its underlying mechanisms. Recruitment will target three chronic inflammatory diseases: chronic liver disease (CLD) (n=50), with a subset of NAFLD (n=20), inflammatory bowel disease (IBD) (n=50) and rheumatoid arthritis (RA) (n=50) both before and after therapeutic intervention. In addition, 20 age and sex matched healthy individuals will be recruited for comparison. Participants will undergo 4 assessment visits at weeks 0, 2, 12 and 24. Visits will consist of the following assessments: blood tests, anthropometrics, functional assessment, quadriceps muscle imaging, actigraphy, quality of life questionnaires, food diary collection and muscle biopsy of the vastus lateralis (at weeks 2 and 24 only). In addition, stool and urine samples will be collected for future microbiome and metabolomics analysis. Discussion This is the first study to use a multi-modal assessment model to phenotype sarcopenia in these chronic inflammatory diseases. We hope to identify generic as well as disease-specific mechanisms driving sarcopenia. We appreciate that these cohorts do require separate standards of care treatments which limit comparison between groups. Ethics and dissemination The study is approved by the Health Research Authority - West Midlands Solihull Research Ethics Service Committee Authority (REC reference: 18/WM/0167). Recruitment commenced in January 2019 and will continue until July 2021. The study was halted in March 2020 and again in January 2021 with the COVID-19 pandemic. The findings will be disseminated through peer-reviewed publications and conference presentations. All data will be stored on a secure server. Trial registration ClinicalTrials.gov Identifier: NCT04734496

scholarly journals Long-Term Survival After Venous Thromboembolism: A Prospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Henning Nilius ◽  
Tamara Mertins ◽  
Robin Boss ◽  
Matthias Knuchel ◽  
Eva Blozik ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Anticoagulant Treatment ◽  
Term Survival ◽  
Cardiovascular Comorbidities

Background: Little is known about long-term survival after the initial treatment of venous thromboembolism (VTE). In a prospective cohort study, we aimed to assess the long-term mortality and key predictor variables relating to disease severity, treatment intensity, and comorbidities.Materials and Methods: Between 1988 and 2018, 6,243 consecutive patients with VTE from a University outpatient unit were prospectively included and followed until December 2019; clinical characteristics, measures of disease severity, and treatment details were recorded. Dates of death were retrieved from the Swiss Central Compensation Office.Results: Overall, 254 deaths occurred over an observation period of 57,212 patient-years. Compared to the Swiss population, the standardized mortality ratio was 1.30 (95% CI: 1.14, 1.47; overall mortality rate: 4.44 per 1,000 patient-years). The following predictors were associated with increased mortality: Unprovoked VTE (hazard ratio [HR]: 5.06; 95% CI: 3.29, 7.77), transient triggering risk factors (HR: 3.46; 95% CI: 2.18, 5.48), previous VTE (HR: 2.05; 95% CI: 1.60, 2.62), pulmonary embolism (HR: 1.45, 95% CI: 1.10, 1.89), permanent anticoagulant treatment (HR: 3.14; 95% CI: 2.40, 4.12), prolonged anticoagulant treatment (7–24 months; HR: 1.70; 95% CI: 1.16, 2.48), and cardiovascular comorbidities. Unprovoked VTE, previous VTE, permanent and prolonged anticoagulation remain independent risk factors after adjustment for age, sex, and comorbidities.Conclusion: Survival after VTE was significantly reduced compared to the Swiss general population, especially in patients with more severe disease, cardiovascular comorbidities, and longer anticoagulant treatment.

scholarly journals Impact of red and processed meat and fibre intake on treatment outcomes among patients with chronic inflammatory diseases: protocol for a prospective cohort study of prognostic factors and personalised medicine

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018166 ◽  
Author(s):  
Robin Christensen ◽  
Berit L Heitmann ◽  
Karina Winther Andersen ◽  
Ole Haagen Nielsen ◽  
Signe Bek Sørensen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Treatment Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Inflammatory Diseases ◽  
Personalised Medicine ◽  
Lifestyle Factors ◽  
Chronic Inflammatory Diseases

IntroductionChronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly implicated in the aetiology of these diseases. Up to one-third of patients do not, however, respond to biologics, and lifestyle factors are assumed to affect treatment outcomes. Little is known about the effects of dietary lifestyle as a prognostic factor that may enable personalised medicine. The primary outcome of this multidisciplinary collaborative study will be to identify dietary lifestyle factors that support optimal treatment outcomes.Methods and analysisThis prospective cohort study will enrol 320 patients with CID who are prescribed a TNFi between June 2017 and March 2019. Included among the patients with CID will be patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis), rheumatic disorders (rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis), inflammatory skin diseases (psoriasis, hidradenitis suppurativa) and non-infectious uveitis. At baseline (pretreatment), patient characteristics will be assessed using patient-reported outcome measures, clinical assessments of disease activity, quality of life and lifestyle, in addition to registry data on comorbidity and concomitant medication(s). In accordance with current Danish standards, follow-up will be conducted 14–16 weeks after treatment initiation. For each disease, evaluation of successful treatment response will be based on established primary and secondary endpoints, including disease-specific core outcome sets. The major outcome of the analyses will be to detect variability in treatment effectiveness between patients with different lifestyle characteristics.Ethics and disseminationThe principle goal of this project is to improve the quality of life of patients suffering from CID by providing evidence to support dietary and other lifestyle recommendations that may improve clinical outcomes. The study is approved by the Ethics Committee (S-20160124) and the Danish Data Protecting Agency (2008-58-035). Study findings will be disseminated through peer-reviewed journals, patient associations and presentations at international conferences.Trial registration numberNCT03173144; Pre-results.

scholarly journals Growth Patterns of Clostridium difficile – Correlations with Strains, Binary Toxin and Disease Severity: A Prospective Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (9) ◽  
pp. e0161711 ◽  
Author(s):  
Sarah Tschudin-Sutter ◽  
Olivier Braissant ◽  
Stefan Erb ◽  
Anne Stranden ◽  
Gernot Bonkat ◽  
...  
Keyword(s):  
Cohort Study ◽  
Clostridium Difficile ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Growth Patterns ◽  
Binary Toxin

scholarly journals Clinical profile and factors associated with COVID-19 in Cameroon: a prospective cohort study

2021 ◽  
Author(s):  
Nicole Fouda Mbarga ◽  
Epee Emilienne ◽  
Marcel Mbarga ◽  
Patrick Ouamba ◽  
Herwin Nanda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Distress ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Multivariable Analysis ◽  
Age Groups ◽  
Clinical Signs ◽  
Case Fatality ◽  
Factors Associated

AbstractObjectivesThis study explores the clinical profiles and factors associated with COVID-19 in Cameroon.Research design and methodsIn this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk.ResultsA total of 323 patients were admitted during the study period; 262 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (77%; N=204) to moderate (15%; N=40) to severe (7%; N=18); the case fatality rate was 1% (N=4). Dysgusia (46%; N=111) and hyposmia/anosmia (39%; N=89) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; N=53), of which hypertension was the most common (20%; N=48). Participation in a mass gathering (OR=5.47; P=0.03) was a risk factor for COVID-19. Age groups 60 to 69 (OR=7.41; P=0.0001), 50 to 59 (OR=4.09; P=0.03), 40 to 49 (OR=4.54; P=0.01), male gender (OR=2.53; P=0.04), diabetes (OR= 4.05; P= 0.01), HIV infection (OR=5.57; P=0.03), lung disease (OR= 6.29; P=0.01), dyspnoea (OR=3.70; P=0.008) and fatigue (OR=3.35; P=0.02) significantly predicted COVID-19 severity.ConclusionUnlike many high-income settings, most COVID-19 cases in this study were benign with low fatality. Such findings may guide public health decision-making.

scholarly journals The Persistence of Natural SARS-CoV-2 Antibodies 12 Months Post COVID-19, a Prospective Cohort Study.

2021 ◽  
Author(s):  
F. Jurgens ◽  
B. Hogema ◽  
S. Siegerink ◽  
L. Samwel ◽  
R. van Gils ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Post Infection ◽  
Prospective Cohort ◽  
Natural Course ◽  
Antibody Isotypes ◽  
Iga Antibodies

Abstract Background: It is unknown how long SARS-CoV-2 antibodies persist after COVID-19. The natural course of anti-SARS-CoV-2 antibodies was analyzed in a large post-COVID-19 cohort, until 12 months post-infection. Methods: The total antibodies SARS-CoV-2 (IgM and IgG) were tested in a cohort of patients with different COVID-19 disease severity sampled at 4 timepoints up to 12 months post COVID-19. In 23 randomly selected patients, the antibody isotypes: anti-spike IgM, IgA and IgG and anti-nucleocapsid IgG were analysed. Results: In total 152/153 patients (99%) tested positive for total anti-SARS-CoV-2 after 12 months of COVID-19; 3 patients tested positive at 8 to 10 months post infection just before vaccination. The SARS-CoV-2 antibody subclasses anti-nucleocapsid IgG, anti-spike IgG and IgA were all still detectable after 12 months. Anti-spike IgM waned after 12 months in the majority of patients.Conclusion: IgG and IgA antibodies against SARS-CoV-2 persisted 12 months post-COVID-19.

scholarly journals Relationship Between Enteropathogen and Acute Gastroenteritis Disease Severity: A Prospective Cohort Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S364-S364
Author(s):  
Stephen Freedman ◽  
Jianling Xie ◽  
Alberto Nettel-Aguirre ◽  
Bonita Lee ◽  
Linda Chui ◽  
...  
Keyword(s):  
Cohort Study ◽  
Disease Severity ◽  
Prospective Cohort Study ◽  
Acute Gastroenteritis ◽  
Prospective Cohort ◽  
Rectal Swab ◽  
Severe Disease ◽  
Molecular Diagnostic ◽  
Emergency Department Care ◽  
Norovirus Gii

Abstract Background Little is known about the association between specific enteropathogens and disease severity in outpatient children with acute gastroenteritis. Recent advances in diagnostics enabling the rapid and simultaneous detection of common enteropathogens have become readily available. While such knowledge can be used to optimize therapy it also has the potential to predict disease severity. Such knowledge can aid clinical decision making, can clarify guidance and expectations provided to families, and can guide public health policy. Methods We conducted a prospective cohort study of children with acute gastroenteritis who were brought for emergency department care. The primary outcome measure was the 20-point Modified Vesikari Scale (MVS) score calculated from symptom onset until day14 of follow-up (total MVS score). Stool and/or rectal swab specimens were collected and analyzed for 18 unique pathogens by molecular diagnostic assays (in-house 5 virus panel, Luminex xTAG Gastrointestinal Pathogen Panel) and/or bacterial culture. An enteropathogen was deemed to be present if a candidate pathogen was identified in the rectal swab or stool specimens by any testing method. Binary logistic regression was performed to assess the association between pathogens (including all pathogens as present or not) and disease severity with the dependent variable being the total MVS score categorized as severe (11–20 points) vs.. non-severe (0–10 points). Results The mean total MVS score (SD) was 12.8 (3.2) and 73.0% (807/1102) of participants experienced severe disease. A pathogen was identified in 72.8% (802/1102) of study participants. Rotavirus, norovirus GII and adenovirus were identified in 26.6% (293/1102), 23.0% (253/1102) and 16.0% (176/1102) of participants respectively. After adjusting for other pathogens significant predictors of severe disease were: rotavirus (OR=8.0; 95% CI: 4.8, 13.2), Salmonella (OR=5.4; 95% CI: 1.2, 24.4), adenovirus (OR=2.1; 95% CI: 1.3, 3.3), and norovirus GII (OR=1.8; 95% CI: 1.3, 2.6). Clostridium difficile (OR=1.6; 95% CI: 0.96, 2.6) and Aeromonas (OR=0.97; 95% CI: 0.2, 4.7) were not significantly associated with severe disease. Conclusion In children with acute gastroenteritis, the enteropathogens associated with severe disease included rotavirus, Salmonella, adenovirus and norovirus GII. Disclosures All authors: No reported disclosures.

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